Periodontal disease results in progressive loss of gingival (gum) and alveolar (socket) bone support to the tooth and is caused by bacteria which colonize the tooth surface and occupy the gingival crevice area. This often leads to a pathologic deepening of the normal gingival crevice with subsequent formation of a periodontal pocket. Loss of alveolar bone and inflammation of gingival tissues adjacent to the pocket occurs, manifesting in a periodontal lesion.
Periodontal disease is the major cause of tooth loss in adults worldwide. Bacterial plaque is the principal causative agent of periodontal disease.
Routine daily prevention or removal of plaque by the patient is a sine qua non in periodontal therapy. This involves the use of toothbrushes, floss and various other oral hygiene instruments. These devices require motor skill and dexterity. The daily routines for adequate plaque removal require the patient to be diligent, motivated, educated and skillful. Accordingly, such methods are effective only when used by motivated individuals and then often to a limited extent.
Traditional periodontal therapy has also emphasized mechanical removal of soft and hard accretions of bacteria (i.e., plaque and calculus) from the root surface via use of dental instruments placed into the gum crevice to mechanically shear the accretions from the tooth structure. See S. Kakehashi and P.F. Parakkal, Proceedings from the State of the Art Workshop on Surgical Therapy for Periodontitis, J. Periodontal 53:475 (1982).
Systemic chemotherapeutic agents have also been used in periodontal therapy. See R.J. Genco, Antibiotics in the Treatment of Human Periodontal Diseases, J. Periodontol 52:545 (1981). However, systemic delivery (e.g., oral or intramuscular) often does not provide a strong enough concentration of chemotherapeutic agent over an extended period of time to the specific area where required. In addition, the possibility exists that indigenous bacteria may develop resistance to such a method of therapy.
Recent studies have focused on the use of the local delivery of tetracycline to periodontal lesions via non-degradable hollow fibers placed into the lesion with dental instruments. This method has shown considerable promise in transient elimination or control of localized subgingival bacteria. See J.M. Goodson, A. Haffajee, and S.S. Socransky, Periodontal Therapy by Local Delivery of Tetracycline, J. Clin Periodontol 6:83 (1979); and J. Lindhe, et al, Local Tetracycline Delivery Using Hollow Fiber Devices in Periodontal Therapy, J. Clin Periodontol 6:141 (1979). However, a problem with this method is that the non-degradable hollow fibers must be removed after treatment.
The present invention solves these and many other problems associated with current methods for the treatment of periodontal disease.